Pain, swelling, difficulty going up and down stairs …… With the onset of winter, knee problems are gradually becoming more common. How to prevent and control these seemingly common but torturous knee diseases? Next, we will give you a brief introduction to osteoarthritis of the knee.
What is osteoarthritis of the knee?
The knee is the body’s primary weight-bearing joint and has the highest incidence of osteoarthritis in the body. There are many names for osteoarthritis, such as “senile arthritis” and “hypertrophic arthritis” or “deforming arthritis” because of the hypertrophic or deformed appearance of the affected joint. Because the disease begins with degeneration of the articular cartilage, it is also called “degenerative arthritis”.
The accumulation of strain on the knee joint over the years as we age is an important factor in the degenerative changes in the articular cartilage. Some foreign institutions have made statistics on the incidence of osteoarthritis of the knee joint: the incidence is 80% for those over 55 years old, 90% for those over 60 years old, and up to 100% for those over 70 years old. Second, changes in the composition of articular cartilage in the elderly make it less resilient and vulnerable to injury, as well as cartilage degeneration. Changes in cartilage composition and chondrocyte metabolism, various inflammatory injury factors increase the water content of articular cartilage and decrease the proteoglycan content and hyaluronic acid, leading to cartilage degeneration. In addition, injury to the knee joint, congenital anomalies, overweight, family history, climate, diet, and other diseases can all have an impact on the development of knee osteoarthritis.
Signs and Symptoms
1. Knee pain is the most obvious symptom of knee osteoarthritis. Pain can occur in the front, inside or outside of the knee joint, and can occur when walking on level ground or when going up and down stairs. In advanced stages, joint pain at rest can occur, seriously affecting work and life.
2. Swelling of the knee joint, atrophy of the thigh muscles, and inversion or valgus deformity of the knee joint.
3. Due to the pain, swelling and deformity of the knee joint, the normal motor function of the joint is affected, the pain is aggravated by walking with weight, the joint is stiff, the extension and flexion are restricted, the range of motion is reduced, and the ability of working life is decreased.
Diagnosis
The diagnosis of osteoarthritis of the knee is easily made on the basis of history, clinical manifestations and auxiliary examinations.
1. X-ray: X-ray plain film examination is the most basic and important examination method, through which joint tumors, infections, fractures and other diseases can be excluded. In cases of osteoarthritis, due to the wear and tear and exfoliation of joint cartilage, the X-ray plain film may show narrowing of the joint space. In the advanced stage of osteoarthritis, there may be loss of the joint space and even collapse of the joint surface, along with osteosclerosis, cystic lesions, and formation of bone superfluities around the joint. On the X-ray plain film, it can be observed whether there is joint deformity, whether the negative gravity line of the lower limb is changed, and whether there is bony free body in the joint.
2. Magnetic resonance imaging (MRI): MRI is a non-invasive examination with high soft tissue resolution and multi-directional imaging. Due to the complex structure of the knee joint, lesions of the articular cartilage, synovial membrane, meniscus, ligaments and other structures are quite common, and these structures cannot be shown on ordinary X-ray plain films. Magnetic resonance imaging provides a very clear picture of the structures in all parts of the knee joint.
Treatment
1. General treatment
Most patients with osteoarthritis of the affected limb joints are able to lead a normal life. Treatment of the disease should include weight reduction, functional exercise and rest. Weight loss can reduce joint pressure and slow the disease process. Patients with mild to moderate knee osteoarthritis should be given appropriate functional exercises, flexion and extension exercises to increase joint mobility, and increased muscle strength training, but should minimize joint loading, avoid joint collision stress, should avoid kneeling and standing for too long, and avoid repeated up and down step activities. Active rest should be taken. Prolonged recumbency and joint braking can lead to joint stiffness and cause further damage. Local application of heat and physiotherapy to the joint can temporarily relieve pain and reduce inflammation, but it has no effect on the course of the disease.
2.Drug treatment
The use of analgesics and non-steroidal anti-inflammatory and pain-relieving drugs is the main method of treatment for degenerative osteoarthritis. These drugs can relieve pain and reduce inflammation, but long-term use will bring side effects. Glucosamine sulfate and chondroitin sulfate are natural drugs, whose most obvious advantages are simplicity and safety, and can relieve joint pain and joint stiffness, but it is difficult to cure osteoarthritis.
3.Intra-articular injection
Some patients with osteoarthritis can have their pain relieved by intra-articular injections of hormones and sodium glass, but for most patients the therapeutic effect of intra-articular injections is limited and the efficacy is not maintained for a long time, and repeated injections may also accelerate joint degeneration. The latest AAOS guidelines for the treatment of osteoarthritis do not recommend intra-articular sodium glass injections for patients with osteoarthritis.
4.Surgical treatment
Arthroscopic surgery: This is the most commonly used minimally invasive technique. Through 2-3 very small incisions, with the help of an arthroscope, intra-articular examination is completed to clarify the nature and extent of the lesion, while meniscectomy, cartilage repair, cartilage grafting, synovectomy, cruciate ligament rupture reconstruction and other procedures can be performed, with the greatest advantages of minimal trauma, rapid recovery and good results.
Knee joint prosthesis replacement: The bone and cartilage on the surface of the knee joint with artificial biomaterials is used to eliminate pain, relieve symptoms and correct deformities, and restore and improve the function of the knee joint. Knee prosthesis replacement, with over 600,000 surgeries performed worldwide each year, has become one of the most successful orthopaedic surgeries of the 20th century. The number of these procedures is increasing as living standards improve, attitudes change, and society ages in pursuit of a higher quality of life. joint replacement is required for people over 60 years of age with severe knee disorders for which non-surgical treatments have failed. This surgery is usually performed under general or semi-body anesthesia and the operation usually takes less than 90 minutes. It involves the precise removal of the damaged joint surface using special surgical instruments, followed by the installation of an artificial joint prosthesis. Three to four days after surgery, you can walk with assistance and perform functional rehabilitation exercises.